Just presenting another perspective.

Something I have learned in my practice of pediatrics.  I try not to
recommend a specialist to a patient if I am doing a consult.  It is a
courtesy to first speak with the primary physician rather than directly
referring.  This might be part of the anger on the part of the pediatrician.
Perhaps he/she also had other boundary issues.  However I would also be
miffed if my patients were referred to another physician without my being
first informed/consulted.  Also in these days of managed care in the US, most
of the time one MUST go through the primary care physician for a specialist
referral to be approved.

Hope this helps,

Pierrette Mimi Poinsett MD FAAP
Modesto CA